Active NPI
Kimmery Cherise Newsom, LMFT, PHD
- Marriage & Family Therapist
- Eau Claire, WI
National Provider Identifier
1679891568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1091
- Practice address
- 3703 Oakwood Hills Pkwy Ste 100
Eau Claire, WI 54701-4458 - Phone
- (534) 444-4562
- Fax
- (534) 444-4563
- NPI assigned
- May 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1091 | KS | Primary |
Addresses
Primary practice location
3703 Oakwood Hills Pkwy Ste 100
Eau Claire, WI 54701-4458
Mailing address
3703 Oakwood Hills Pkwy Ste 100
Eau Claire, WI 54701-4458
Phone (534) 444-4562
Other practice location 1
1115 Westport Dr
Suite D4
Manhattan, KS 66502-2880
Phone (785) 341-8438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates Counseling Wi., S.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Sagent Behavioral Health
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fargo, ND
- NPI 1104549047
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1679891568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3703 OAKWOOD HILLS PKWY STE 100",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547014458",
"telephone_number": "534-444-4562",
"fax_number": "534-444-4563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3703 OAKWOOD HILLS PKWY STE 100",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547014458",
"telephone_number": "534-444-4562",
"fax_number": "534-444-4563"
}
],
"practiceLocations": [
{
"address_1": "1115 Westport Dr",
"address_2": "Suite D4",
"address_purpose": "LOCATION",
"city": "Manhattan",
"state": "KS",
"postal_code": "665022880",
"country_code": "US",
"telephone_number": "785-341-8438",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NEWSOM",
"first_name": "KIMMERY",
"middle_name": "CHERISE",
"name_prefix": "Dr.",
"credential": "LMFT, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-17",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "KS",
"license": "1091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.